Cost and Insurance
What vein treatment costs, and what insurance covers
The short version: your consultation and ultrasound are usually covered, medically necessary treatment is usually covered after prior authorization, and cosmetic treatment is not covered by insurance. Here is how it works at The Vein Care Center, in plain language.
The short answer
Consultation and ultrasound
For vein related visits, the initial office consultation and venous ultrasound are usually covered by most insurance carriers.
Medically necessary treatment
Varicose veins with documented reflux and symptoms (pain, swelling, skin changes, ulcers) are a medical condition. Varithena, laser ablation, and micro-phlebectomy are usually covered after prior authorization, including by Medicare Part B.
Cosmetic treatment
Spider vein sclerotherapy without symptoms is considered cosmetic and is not covered by insurance. Consultations for cosmetic vein treatment are complimentary.
How coverage works, step by step
1. Consultation and ultrasound
Usually covered by insurance for vein-related visits. You leave with a diagnosis and a plan.
2. Conservative therapy
Most insurers require a documented trial of compression stockings, often six weeks to three months, before approving a procedure. We start the clock at your first visit.
3. Pre-determination
If treatment is medically necessary, we submit a pre-determination letter with your medical records to your carrier for prior authorization.
4. Written estimate
Once we hear back, you get the answer in writing: what is covered and what your plan leaves to you. Nothing is scheduled until you have it.
5. Treatment
Should you decide not to wait for the pre-determination process and would like to proceed with the treatment plan prescribed, you will be responsible for payment at the time of service.
Accepted insurance carriers
The Vein Care Center has extensive knowledge and experience with all medical insurance companies, and will work with you to personalize your needs. We work with major insurers, including:
Not on the list? Call us. We verify benefits for most plans.
Medicare
Medicare Part B covers varicose vein treatment when it is medically necessary: documented reflux on ultrasound plus symptoms or skin changes, usually after a compression trial. We are experienced with Medicare’s documentation requirements and handle the submission. Medicare Advantage plans follow similar rules and may require a referral or prior authorization from the plan.
If your plan does not cover it
You get a written estimate before anything is scheduled, so you know the number before you commit. No surprise bills, and nothing goes on the schedule until you have it in hand.
Payment options
The Vein Care Center accepts all major credit cards and checks. There is also convenient healthcare financing available.
[PLACEHOLDER] Name of the healthcare financing provider (CareCredit or other) and a link to apply. Client to supply.
Check your coverage by phone
Call either office with your insurance card handy. Tammy calls your plan directly to confirm your vein-care benefits, so you know what is covered before your first visit. No obligation, and nothing goes on the schedule until you have the answer.
Common denial reasons, and how we avoid them
Cost and insurance questions
Does insurance cover varicose vein treatment?
Usually yes, when it is medically necessary: the ultrasound shows reflux and you have symptoms such as pain, swelling, or skin changes. Most plans require a compression-stocking trial first and prior authorization. We submit the pre-determination for you.
Does Medicare cover varicose vein treatment?
Medicare Part B covers medically necessary vein procedures. Cosmetic spider vein treatment is not covered. We are experienced with Medicare’s requirements.
Is spider vein treatment covered by insurance?
Usually not, because it is cosmetic. Consultations for cosmetic vein treatment are complimentary.
How will I know what I owe before treatment?
You get it in writing. We verify your benefits with your carrier, submit a pre-determination where one is needed, and then give you a written estimate covering what your plan pays and what it leaves to you. Nothing is scheduled until you have that estimate.
What is your financial policy?
On the day of your initial consultation, a treatment plan will be designed specifically for you. Should the treatment plan be considered medically necessary, The Vein Care Center will submit a pre-determination letter along with your medical records to your insurance carrier for prior authorization. Should you decide not to wait for the pre-determination process and would like to proceed with the treatment plan prescribed, you will be responsible for payment at the time of service. The Vein Care Center accepts all major credit cards and checks. There is also convenient healthcare financing available.
Do I need a referral?
Most PPO plans and Medicare do not require one. Some HMO and Medicare Advantage plans do. Call the office with your plan name and we will tell you.
Related reading from our blog
Ready to get started?
Schedule your consultation. We’ll help you understand your coverage and options before anything is scheduled.